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Acute kidney injury (AKI) used to be known as ‘acute renal failure’. But the name was
changed because, in most people with the condition, the kidneys don’t actually ‘fail’
completely: they just suddenly work less well than they did before. This reduced kidney
function can vary from a small amount to complete failure.
The word ‘injury’ in this case doesn’t mean that your kidneys have been physically wounded,
but rather that something has stopped them from working properly.
AKI is most common in people aged over 65. Other things that can increase your chance of
AKI include:
If you have any of these symptoms, seek medical help. And always get urgent medical help if
you have trouble breathing or your heart beats in a way that is not usual.
Nausea and vomiting can also be symptoms of AKI. On their own they don’t usually suggest
anything serious. But if they happen alongside any of the other symptoms, get medical help
straight away.
Your doctor will need to test your blood and urine to confirm whether you have AKI. You may
also need other tests, such as a scan to show whether your kidneys are swollen or if there is
a physical blockage in one or both of your kidneys.
It’s also possible to be over-hydrated when you have AKI. So you might need to take
medication to make you urinate more (a diuretic).
Or you may need a treatment called renal replacement therapy (also known as dialysis),
which means that your blood is filtered so that it contains the right balance of fluids and
nutrients. Having dialysis at this time doesn’t mean that you’ll need to keep having dialysis
regularly. You might just need it once.
Drug treatments
If you are severely dehydrated because of AKI it can reduce how much blood you have in
your veins and arteries. This can cause your blood pressure to fall too low. You may need to
be given medication to raise your blood pressure until your blood level is back to normal.
In some people with AKI the body’s immune system can start to attack the kidneys. If this has
happened to you, you will be given drugs that help stop the immune system from reacting in
this way.
You may also need drugs called steroids (the full name is corticosteroids) to help reduce
swelling in your kidneys. (These are not the same as the anabolic steroids used by some
bodybuilders and athletes.) And you may need drugs to treat any infection that might have
caused the AKI.
You may need to stop taking some medicines for a time while your kidneys recover. For
example, you will need to stop taking any medicines that contain sodium (salt).
If your doctor suspects that you have a blockage in a kidney, you will need to have a tube
called a catheter inserted to help drain the build-up of urine caused by the blockage.
The catheter is passed through the urethra (the tube that carries urine from your kidneys out
of your body). So you don’t need to have surgery to have it fitted.
This will happen even before the doctor knows for sure that you have a blockage, because
it’s important that a kidney that contains a build-up of urine is drained quickly. If a blockage is
then found you will then need surgery or another procedure to remove it.
Dialysis
Dialysis is a treatment where a machine takes over the job of cleaning the blood that the
kidneys normally do. You may need this treatment if your kidney function has dropped to a
very low level. You will need to be connected to the machine by a tube in one of your veins.
Some people do not recover all their kidney function and go on to develop chronic kidney
disease or kidney failure. If this happens to you, your doctor will talk to you about the
treatment you will need in the future, which could include regular dialysis.
Some people die from AKI, although the cause of death is often an underlying condition that
caused the kidney problems, rather than AKI itself. Death is more likely in people whose AKI
is more severe.
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